Objectives To study the compliance of clinical and US lesions of plantar aponeurosis in patients with eSpA.
Methods The study included 126 patients with eSpA (the average age is 28.9±7.3 years): 72 (58.2%) patients with axial spondyloarthritis (aSpA, ASAS 2009) and 54 (41.8%) with peripheral (pSpA, ASAS 2011). 58.7% of them were women, 84.2% were HLAB27 positive. The study was included clinical (heel pain when walking and palpation) and US examination of the heel (thickening of the plantar aponeurosis, heterogeneity, insertion of plantar aponeurosis into calcaneal bone). US investigation was performed by MyLab Twice ultrasound device (Esaot, Genova, Italy). Disease activity was measured by BASDAI, BASFI and ASDASCRP scales.
Results 110 out of 126 patients (87.3%) had no clinical signs of plantar fasciitis, 16 (12.7%) patients had heel pain when walking and palpation, US lesions of plantar fasciitis were found in 41 (32.5%) patients. 31 (28.2%) out of 110 patients without pain had US signs of plantar fasciitis. 11 (68.7%) out of 16 patients with pain syndrome had US signs of plantar fasciitis. 126 patients were divided into 4 groups; data are presented in table 1.
A comparative analysis of the disease activity between different groups of patients has shown that patients of group 1 with heel pain syndrome and US lesions indexes of activity were significantly higher than in other groups. BASDAI (p=0.001). ASDASCRP (p=0.003). Also patients in group 3 with pain syndrome, but without US signs of plantar fasciitis had higher indexes of activity.
Conclusions The study revealed a discrepancy between clinical and US lesions of plantar fascia: clinical signs of inflammation were founded in 12.7% of cases, and US signs in 32.5% of patients. Among patients without pain 28.2% had signs of plantarn fasciit. Indexes of activity were significantly higher in patients with pain, even without US lesions of plantarn fascia.
Disclosure of Interest None declared